Abstract
The manometric and cineradiographic features of 14 patients with oropharyngeal dysphagia are described. Failure of the upper-esophageal sphincter (UES) to relax completely and incoordination of UES relaxation with pharyngeal contraction were noted as was poor initiation of swallows and disorganization of pharyngeal contraction. The relative merits of cine esophagography and esophageal manometry in evaluating oropharyngeal dysphagia are assessed, and a functional classification for this disorder is proposed. Clinical improvement in 4 of 5 patients who underwent UES myotomy for severe intractable dysphagia did not always correlate with improvement in manometric and cine studies.
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References
Phillips MM, Hendrix TR: Dysphagia. Postgrad Medicine 50:81–86, 1971
Atkinson M, Kramer P, Wyman SM, Ingelfinger FJ: The dynamics of swallowing. I. Normal pharyngeal mechanisms. J Clin Invest 36:581–588, 1957
Ingelfinger FJ: Esophageal motility. Physiol Rev 38:533–584, 1958
Code CF, Schlegel JF: Motor action of the esophagus and its sphincters, Handbook of Physiology, Section 6. Vol 4. 1968, pp. 1821–1839
Dodds WJ, Hogan WJ, Reid DP, Stewart ET, Stef JJ, Arndorfer RC: Evaluation of pharyngeal peristalsis using a strain sensitive recording system. Gastroenterology 62:743, 1972 (Abstract)
Sokol ME, Heitmann P, Wolf BS, Cohen BR: Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx and cervical esophagus. Gastroenterology 51:960–974, 1966
Cohen BR, Wolf BS: Cineradiographic and intraluminal pressure correlations in the pharynx and esophagus, Handbook of Physiology, Section 6. Vol. 4. 1968, pp 1841–1860
Winans CS: The pharyngoesophageal closure mechanism: A manometric study. Gastroenterology 63:768–777, 1972
Fox JE, Vidins EI, Beck IT: Observer variation in esophageal pressure assessment. Gastroenterology 65:844–888, 1973
Donner MW, Silbiger ML: Cinefluorographic analysis of pharyngeal swallowing in neuromuscular disorders. Am J Med Sci 251:600–616, 1966
Pope CE: Physiology (of the Esophagus). Gastrointestinal Disease. Edited by MH Sleisenger, JS Fordtran. Philadelphia, WB Saunders Co, 1973, pp 83–89
Hightower NE: Swallowing and esophageal motility. Am J Dig Dis 3:562–583, 1958
Stevens KM, Newell RC: Cricopharyngeal myotomy in dysphagia. Laryngoscope 81:1616–1620, 1971
Fischer RA, Ellison GW, Thayer WR, Spiro HM, Glaser GH: Esophageal motility in neuromuscular disorders. Ann Intern Med 63:229–284, 1965
Bonanno PC: Swallowing dysfunction after tracheostomy. Ann Surg 174:29–33, 1971
Litton WB, Leonard JR: Aspiration after partial laryngectomy. Cineradiographic studies. Laryngoscope 79:877–908, 1969
Calne DB, Shaw DG, Spiers ADS, Stern GM: Swallowing in parkinsonism. Br J Radiol 43: 456–457, 1970
Bosma JF, Brodie DR: Disabilities of the pharynx in amyotrophic lateral sclerosis as demonstrated by cineradiography. Radiology 92:97–103, 1969
Winship DW, Caflisch CR, Zboralske FF, Hogan WJ: Deterioration of esophageal peristalsis in patients with alcoholic neuropathy. Gastroenterology 55:173–198, 1968
Mandelstam P, Lieber A: Esophageal dysfunction in diabetic neuropathy-gastroenteropathy. JAMA 201:582–586, 1967
Mandelstam P, Siegel CI, Lieber A, Siegel M: The swallowing disorder in patients with diabetic neuropathy-gastroenteropathy. Gastroenterology 56:1–12, 1969
Goyal RK, Spiro HM: Esophageal function in diabetes mellitus. Ann Intern Med 72:281–282, 1970
Kramer P, Atkinson M, Wyman SM, Ingelfinger FJ: The dynamics of swallowing. II. Neuromuscular dysphagia of pharynx. J Clin Invest 36:589–595, 1957
Siegel CI, Hendrix TR, Harvey JC: The swallowing disorder in myotonia dystrophica. Gastroenterology 50:541–550, 1966
Garrett JM, DuBose TD, Jackson JE, Norman JR: Esophageal and pulmonary disturbances in myotonia dystrophica. Arch Intern Med 123:26–32, 1969
Goldberg HI, Sheft DG: Esophageal and colon changes in myotonia dystrophica. Gastroenterology 63:134–139, 1972
Blakeley WR, Garety EJ, Smith DE: Section of the cricopharyngeus muscle for dysphagia. Arch Surg 96:745–760, 1968
Payne WS, Clagett OT: Pharyngeal and esophageal diverticula. Current Problems in Surgery. Chicago, Yearbook Medical Publishers, 1965
Ellis FH, Schlegel JF, Lynch VP, Payne WP: Cricopharyngeal myotomy for pharyngoesophageal diverticulum. Ann Surg 170:340–349, 1969
Ellis FH: Upper esophageal sphincter in health and disease. Surg Clin N Am 51:533–565, 1971
Brindley GV: Neuromuscular disorders of the esophagus. Surg Clin N Am 52:319–331, 1972
Sutherland HD: Cricopharyngeal achalasia. J Thocar Cardiovasc Surg 43:114–126, 1962
Parrish RM: Cricopharyngeus dysfunction and acute dysphagia. Can Med Assoc J 99:1167–1171, 1968
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Hurwitz, A.L., Nelson, J.A. & Haddad, J.K. Oropharyngeal dysphagia. Digest Dis Sci 20, 313–324 (1975). https://doi.org/10.1007/BF01237788
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DOI: https://doi.org/10.1007/BF01237788